Provider Demographics
NPI:1740713262
Name:MYERS PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:MYERS PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH MYERS
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:214-329-2165
Mailing Address - Street 1:9550 SPRING GREEN BLVD
Mailing Address - Street 2:STE. 408-120
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3758
Mailing Address - Country:US
Mailing Address - Phone:214-336-5264
Mailing Address - Fax:
Practice Address - Street 1:2855 WESTMINSTER PLAZA DR
Practice Address - Street 2:WELLNESS CENTER
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2960
Practice Address - Country:US
Practice Address - Phone:214-329-2165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1248599261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy